DESCRIPTION (Applicant's abstract): This study examines therapeutic foster care for youths with serious emotional disturbance and aggressive behavior. Therapeutic foster care arc has become one of the most common out-of-home placements for difficult to treat youths TFC involves residential placement of a youth in the private home of a family that has received special training. It combines the possibility of intensive treatment with opportunities for development within a family- and community-based environment. Findings from several randomized trials suggest that TFC is efficacious. The proposed study builds upon these findings to explore how and whether therapeutic foster care works under conditions of real world implementation. It addresses three specific aims: (1) to determine factors associated with use of therapeutic foster care in a system of care; (2) to assess implementation of therapeutic foster care; and (3) to examine effectiveness of therapeutic foster care. The study is a Public-Academic Liaison with the State of North Carolina. The sample includes youths participating in North Carolina's Willie M program. This sample will include approximately 1,200 youths, of whom 275 will receive TFC at some time during the one your period following sample selection (October 1998 - September 1999). Data will be obtained from agency representatives, ongoing Willie M data collection, and in- person and telephone interviews with youths in TFC and treatment parents. Data will be collected while youths reside in TFC and for 18 months after discharge. This project will substantially increase the field's knowledge of how TFC is use, for whom it is used, and under what conditions it is most effective. Such information will allow more effective and efficient planning and use of TFC is Systems of care for youths.